Name: Drug Free Business
Address: 18912 N Creek Pkwy #202, Bothell, WA, 98011, US
Telephone: +1 425-488-9755

Owner/Operator Clearinghouse Consent

Dear FMCSA Owner- Operator,
Action required!
An owner-operator—an employer that employs himself or herself as a CDL driver, typically a single-driver operation—must designate the C/TPA in the Clearinghouse. An owner-operator must run an annual limited query in the Clearinghouse. If you would like Drug Free Business to run this query on your behalf, we need the consent form below filled out and submitted to us as soon as possible so we have it on file to run the annual limited query for this year.
NOTICE TO DRIVER: The Commercial Driver's License (CDL) Drug & Alcohol Clearinghouse is a federal database containing information about CDL drivers who have violated the Federal Motor Carrier Safety Administration's (FMCSA's) drug or alcohol regulations in 49 CFR Part 382. Whether you have committed such a violation or not, each motor carrier for whom you drive is required to check whether the Clearinghouse has any information about you, both at the time of hire and annually. When conducting an annual inquiry, the motor carrier has the option to request a "limited" report that only indicates whether the Clearinghouse has any information about you; it does not release any violation or testing information. Before a motor carrier may request a limited report, they must have your written authorization, per §382.701 (b). This authorization may be valid for more than one year. If a limited query ever reveals that the Clearinghouse has information about you, you will be required to log in to the Clearinghouse website within 24 hours to grant electronic consent for the motor carrier to obtain your full Clearinghouse record. NOTICE TO MOTOR CARRIER: This consent form authorizes Drug Free Business to run a "limited query" to check whether the Clearinghouse has information about the driver identified below. If it does, then you must obtain a full Clearinghouse record within 24 hours, per §382.701 (b). This consent form must be retained until 3 years after the date of the last limited query you perform for this driver, based on the authorization below.
I hereby authorize (enter name of motor carrier)*
to conduct limited annual queries of the FMCSA's Drug & Alcohol Clearinghouse, to determine if a Clearinghouse record exists for me. This consent is valid from the date shown below until my employment with the above-named motor carrier ceases or until I am no longer subject to the drug and alcohol testing rules in 49 CFR Part 382 for the above-named motor carrier. I understand that if any limited query reveals that the Clearinghouse contains information about me, I must grant electronic consent within 24 hours, via the Clearinghouse website, for the motor carrier to obtain my full Clearinghouse record. Refusal to provide such consent will result in my removal from safety-sensitive duties.
Driver's Name*
First Last
CDL Number and State of Issuance*
DOB (must be included in a Clearinghouse query)*
Month
Day
Year
By submitting your information you acknowledge it is correct and are giving authorization for your motor carrier to conduct limited annual queries to the FMCSA's Drug & Alcohol Clearinghouse.
Driver's email*

Owner/Operator Clearinghouse Consent

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